Member Forms

member Retirement Forms
Form #	Description	Last Updated	Non-fill	Fillable
VRS-2	Designation of Beneficiary To designate more than 4 beneficiaries, a continuation form, the VRS-2A, is also required.	07/2009	42kb	169kb
VRS-2A	Designation of Beneficiary - Continuation	07/2009	30kb	153kb
VRS-3ORP	Request for Transfer of Refund to ORP	07/2006	38kb	178kb
VRS-5	Application for Retirement	07/2009	49kb	201kb
VRS-6	Application for Disability Retirement	07/2009	48kb	203kb
VRS-6A	Explanation of Disability	04/2008	30kb	166kb
VRS-6B	Physician's Report	11/2008	51kb	228kb
VRS-6C	Request for Estimate of Disability Retirement Benefits	07/2003	96kb	248kb
VRS-6D	Employer Information for Disability Application	11/2008	23kb	133kb
VRS-15	Request for Income Tax Withholding	07/2005	61kb	164kb
VRS-45	Request for Health Insurance Credit Retired participants who do not have premiums deducted from their VRS monthly benefit must complete this form.	11/2008	70kb	178kb
VRS-57	Authorization for Direct Deposit of Monthly Benefit	07/2008	27kb	144kb
VRS-60	Request for Estimate of Retirement Benefits	06/2003	69kb	229kb
VRS-65	Election to Participate - ORP for Higher Education	05/2008	28kb	138kb
VRS-65D	Termination Certification Form- ORP for Higher Education	06/2009	31kb	110kb
VRS-65E	Termination Certification Form - Optional Retirement Plan for Political Appointees	06/2009	33kb	112kb
VRS-71B	Termination Certification Form - ORP for School Superintendents	08/2009	29kb	107kb
VRS-75	ORP Health Insurance Credit Employer Certification of Service Completed only by employers certifying ORP participants.	11/2008	35kb	148kb